| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $120.93 | $120.93 | $120.93 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $120.93 | $120.93 | $120.93 |
Unlisted procedure, therapeutic radiology clinical treatment planning
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $120.93 | $120.93 | $120.93 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $120.93 | $120.93 | $120.93 |